Primary care in our current health system is fragmented, inefficient, and frequently unsafe. The proposed[unreadable] research entitled Ambulatory Care Compact to Organize Risk and Decision Decision-making (ACCORD) will[unreadable] design, develop, implement, and evaluate an innovative model of care delivery that enables patients and[unreadable] and primary care providers (PCPs) to agree upon shared, follow follow-up care plans that incorporate patient and provider preferences. This ?compact? between a patient and his or her own PCP will be supported by an information[unreadable] architecture and software designed to facilitate the creation, initiation, and longitudinal tracking of these[unreadable] preferred care plans. This proposal will test the following hypotheses: 1) Patients will partner with their PCPs [unreadable] to establish a clinical compact as an agreement to follow follow-up care plans in domains of preventive medicine,[unreadable] abnormal findings follow follow-up, and therapeutic drug monitoring; 2) A clinical informatics architecture can be[unreadable] designed within an established PBRN to create and track these clinical compacts and to make visible any[unreadable] departures from plan; and 3) This patient patient-centered primary care model will result in better patient, provider, and[unreadable] quality of care outcomes compared to usual care. The impact of the ACCORD model on the patient?s[unreadable] experience of care and quality of preventive care will be evaluated in a randomized clinical trial of 12 primary[unreadable] care practices at Massachusetts General Hospital (MGH) within our Practice Practice-Based Research Network[unreadable] (PBRN) that serve a diverse patient population in Eastern Massachusetts.[unreadable]